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Friday, January 19, 2018

Measles at O’Hare Airport!

A new year, signifies the start of a new tradeshow calendar
of events meaning, I start packing my bags and booking flights. Traveling is a bit like Russian roulette, as
once you walk in the front door of an airport you’re in close quarters on
planes, trains, elevators, security lines and bathrooms. Heck let's face it, virtually any area of the
airport you’re in you’re lucky to have a foot of free space around you. In the infection control world this is bad
because we know respiratory droplets can travel. In fact a study I found from 2007
showed that respiratory droplets varied in how far they could
travel depending on their size and how they “left” the body. They found that large droplets are carried
more than 6 m away by sneezing, more than 2 m away when you're coughing and less
than 1 m away when breathing normally. Hmmm, I say.
I may need to invest in a bubble to wear when travelling.

As I mentioned in my “Welcome to 2018” blog, you never know
where the next outbreak may come. You
may be wondering why I’m talking about airports and the distance respiratory
droplets travel. Well, if you haven’t
heard, a passenger
with an ACTIVE case of measles recently arrived (January 10th) at
O’Hare Airport in Chicago. They arrived
on an international flight landing into terminal 5 and departed on a domestic flight
that left from terminal 1. For those
that have been at O’Hare that leaves a lot of ground to cover, people to come
in contact with and surfaces that could be touched.

Why care about a single infected person who has been on a
plane (confined space), or walking around an airport? Well…there is a reason why Public Health
panics and promotes vaccination. Measles
is spread to others through coughing and sneezing (think 2 – 6 meter radius). If that’s not bad enough, this highly
infectious virus can live for up to two hours in an airspace where the infected
person coughed or sneezed meaning if people breathe the contaminated air or
touch the infected surface, then touch their eyes, noses, or mouths, they can
become infected. If we’re willing to be
honest we know that in public spaces like this, surfaces are not likely cleaned
more than once every 24 hours except perhaps for bathrooms. This is certainly something to consider
particularly as according
to the CDC, measles is so contagious that if one person has it, 90% of the
people close to that person who are not immune will also become infected. I wonder what type of plane this person was
travelling on…

If one person with active measles is not bad enough,
apparently a second
measles infected person has been identified. This person arrived at the airport on January
9 (also arriving in Terminal 5) and also visited an office plaza and three
suburban hospitals between January 10th and 13th.

On a positive note, vaccination rates in
children for MMR (the vaccine that covers measles) in the US is about 92%. The negative side, is that there is data now
showing that twenty years after a second MMR vaccination, antibody levels for
all 3 viruses in the MMR vaccine wanes. In
Canada, MMR was introduced in 1983 which saw a significant decrease in the
number of cases. In 1997, a two-dose
vaccination protocol was introduced. This means there could be a number of adults who only received 1-dose of
the MMR vaccination. If your GP does not
routinely screen for antibody levels to some of the vaccine preventable diseases
and you’re like me and only received a single dose in my childhood you may want
to check out your antibody levels. I had
mine checked a couple of years ago after an outbreak of measles at a university
happened in a population of immunized students. My levels showed my immunity was questionable but with a quick shot to
my arm I’m now completely covered!

I will admit, I avoid O’Hare at all costs. I don’t have anything against the city of
Chicago. I just don’t like missing
connecting flights due to snow and rain storms that seem to be so prevalent in
that part of the country!